风湿性心脏病二尖瓣狭窄左房血栓形成的相关因素

目的：探讨风湿性心脏病二尖瓣狭窄(风心二狭)患考左房血栓形成的相关因素。方法：162例风心二狭并行心脏外科手术治疗患，术前常规做经胸心脏彩超检查，术中仔细寻找左房血栓。结果：房颤、二尖瓣返流是风心二狭思考左房血栓形成的相关因素，其相对危险度分别是17．744、0．468。年龄、左室舒张末期内径、左室射血分数、二尖瓣口面积在单因素分析中表现出一定的相关性，但在逐步logistic回归分析中并无统计学意义。在二尖瓣返流患中，随着返流的加重，左房血栓发生率下降。结论：风心二狭病人，房颤患易形成左房血栓。二尖瓣返流对血栓形成起保护作用，二尖瓣口面积与血栓形成的关系尚需进一步明确。

Correlation factor of left atrial thrombosis in patients with rheumatic mitral stenosis

Objective: To investigate the independent factors associated with left atrial(LA) thrombosis in patients with rheumatic mitral stenosis. Methods: Transthoracic echocardiography were performed in 162 patients with mitral stenosis who would undergo surgical operation. All patients were carefully examined for thrombosis during the operation. Results: Atrial fibrillation, mitral regurgitation were found to be risk factors of left atrial thrombosis, whose odds ratios were 17-744 and 0.468 respectively. Age, left ventricular end-diastolic volume^ left ventricular ejection fraction and mitral valve area show definite relation in single factor dialysis, but without statistical significance in step to step logistic regression. The heavier the mitral regurgitation, the lower the left atrial thrombosis. Conclusion: In patients with rheumatic mitral stenosis, atrial fibrillation is apt to growth left atrial thrombosis, mitral regurgitation protects from left atrial thrombosis formation. Author's address: Wuhan Asia Heart Disease Hospital, Wuhan, Hubei, 430022